摘要
目的 评价MRI对经皮超声引导射频消融治疗肝癌术近期疗效的价值。方法 对80例经皮超声引导射频消融治疗肝癌术中的48例患者进行了MRI随访观察。结果 经皮超声引导射频消融治疗肝癌术后病灶随着时间的改变而其MRI表现各有不同。病灶早期(1个月内)T1WI中央区呈高信号或稍高信号,周围呈环行低信号,PDWI和T2WI病灶中央区呈低信号,周围则呈环行高信号。静脉注射Gd-DTPA后中央区无强化,而边缘则呈环行强化。半年后随访病灶则T1WI、PDWI、T2WI则均呈低信号,且无强化。结论 MRI对局部组织损伤后是否存在出血,含铁血黄素的改变,以及判定局部是否存在水肿有着重要的作用。外周环行异常信号区的大小是判断毁损灶大小的最合适标志。其大小与疗效明显相关。
Objective To evaluate the short-term curative effect of percutaneous radiofrequency ablation for hepatic cancer by MRI. Methods Out of the 80 cases of hepatic cancer treated with percutaneous radiofrequency ablation ,48 cases were followed up by MRI. Results The MRI representations of the focus varied with the change of the time length.The three-zone composition of the lesion was seen on all imaging sequences in the early-phase(1 month). Demarcation between the different zones was most clearly seen on the T2- weighted images. Inner zone showed out high signals on the T1 WI, and lower signals on the T2 WI and PDWI; the around zones showed out lower signals on the T1WI but high signals on the T2WI and PDWI.The inner zones could not be enhanced, but the edge-zone was enhanced after injection Gd-DTPA. All lesions showed out lower signals on T1WI and T2WI and PDWI,and could not be enhanced in later-phase(6 months). Conclusion Postoperative MRI is a suitable method for noninvasive examination, including determinant of bleeding and edema of the injured tissues, changing of hemoglobin. The size of outside signal zone is the most suitable reference for the judgement of the destroyed lesion size, and it is clearly related to the curative effect.
